Vision

The Keiskamma AIDS Treatment Program exists in the Peddie district of the Eastern Cape to provide a compassionate center for any patient who needs assistance in treatment of opportunistic infections, initiation and training for use of HAART (highly active antiretroviral therapy), a place to stay while recovering from AIDS and a place to help patients access tertiary care in the tertiary hospital 120 kms away in East London.

We support and advocate people’s rights to access quality health care.

Demography

The Peddie district of Eastern Cape, part of former homeland of Ciskei, has approximately 200,000 people living mostly in rural villages in an area of approximately 3600 square miles. The unemployment in this area is as high as 90% and the majority of people live off government grants or old age pensions of grandparents. Access to medical treatment is severely restricted by poverty and inability to travel to sites offering care.

The hospital central to the district has been accredited to supply ARVS but due to staff shortages and lack of training it is lagging very far behind the need and demand of the population of the district for support and treatment of HIV/AIDS.

In addition to poverty and poor nutrition and poor education of primary care practitioners in the area, TB has become a major problem and many people are now dying of TB diagnosed too late.

The Keiskamma AIDS Treatment center in located in the village of Hamburg at the mouth of the Keiskamma River in the South Eastern corner of this large district. The beautiful natural environment is marred by the poverty of the region, which was previously part of the Ciskei, one of the homelands established by the apartheid government. For most of the residents of the area, access to health care is difficult.

AIDS statistics for Peddie District

The ante-natal infection rate is currently 35%. Therefore the following figures can be extrapolated. The AIDS incidence in the community is 17.5%. In actual numbers this means that 35,000 people are HIV positive. 10% of these need ARVS now. 10% are children. At present there are 3 providers of HAART in the district, IYDSA (a PEPFAR funded programme), the Nompumelelo hospital ARV programme and our own NGO.

To date between us we have initiated approximately 400 people on ARVS since 2005.

It is obvious that we do not yet have the capacity to provide an adequate response to the enormous problem we have in the district.

Keiskamma Health Program

In 2005 there was no HAART available in the district at all until Keiskamma Trust approached a PEPFAR program and persuaded them to work in the area and in partnership with Keiskamma AIDS treatment program. We initiated 195 patients on ARVS.

We realized due to ill health and distance the patients in this area needed somewhere to stay while being prepared for ARVS so we opened our residential center. This was immediately successful as patients felt loved, valued and accepted and formed good relationships with other HIV positive people and our staff.
Since we opened we have had an average bed occupancy of 10 patients a night and 20 new patients admitted per month.

We reach people in the district by means of village health workers trained by us who are in all 26 of the Peddie south villages. It is our challenge to introduce them to all 120 villages in the larger Peddie district.

In 2006 the secondary hospital in our district became accredited to provide ARVS so our function changed to preparing patients for ARVS and then sending them to Nompumelelo hospital for their treatment. We initiated a further 92 patients onto ARVS ourselves as we no longer had access to PEPFAR funding. We help the patients accept and understand their condition, accept themselves and build self-esteem, provide good health care and when their condition is stable we transfer them into either the PEPFAR program or the government system.

In 2007 the doctor responsible for ARV treatment resigned and we worked both within the hospital and within our own trust
Our trust has initiated 31 patients to date in 2007

Health Centre

Central to our program is the health center that we have established in Hamburg. In our rural area, transportation is difficult and expensive, and many of our clients live in distant villages. There is little access to hospitals, and we needed a place where we could provide full time monitoring and care to our sicker patients, especially in the early stages of treatment when complications are likely.

In our health centre we provide 24-hour nursing care, and employ a full-time professional nurse. We are able to provide our patients with regular balanced meals, which is essential to effective treatment. It is a place where people can learn to follow the complicated drug regimens in a supportive and nurturing environment.

Our health center is run on a principle of community involvement, and we make our relationships with community structures, church groups and local political entities a high priority. Community members, many of whom are struggling to support their own families, have donated their time and energy to making the project a success. There is a steady stream of women bringing vegetables from their gardens to the kitchen door.

Gardening Project

Nutrition is an essential part of the fight against aids in the body. We have established a vegetable garden in the grounds of the health center to provide resident clients with fresh vegetables.

We have also started a small high-yield, low area garden. We are encouraging villagers to learn these techniques and to start gardens of their own. We supply the initial seeds.

Education and Training

One of the main barriers to the successful provision of HIV care in South Africa is the lack of suitably trained care workers. We provide continued training to our own staff as well as to provincial health care workers. We have organized training workshop with specialists for care providers in our area.

Our training involves understanding of HAART initiation and monitoring, diagnosis and treatment of opportunistic infections and counseling a social support. We have been instrumental in 2007 of introducing PCR testing of 6 week old exposed infants in all but 2 of 20 government clinics where we work. We have an aggressive PMTCT (Preventing Mother-To-Child-Transmission) program and encourage the government clinics to offer HIV testing to all pregnant mothers.

Cooperation with Government Programmes

Our long-term goal is to integrate our program with the primary and secondary health care structures in our area. Building capacity in local structures is one of our major priorities. We are already integrated to a high degree with the local primary care clinics, and are building a relationship with our local hospital. We are proud of the fact that our involvement in this is one of the factors that has led to the hospital receiving accreditation as an ARV rollout site.

Finances and Budget

We are supported by three major donors and many smaller organizations and individuals. Our major donors are 25:40, based in Washington USA, John Brown and friends based in London and Bjorn Ronneberg and friends in Norway. It is due to the hard work and generosity of these people that we have been able to keep the treatment programme running for the past 3 years.

We are also particularly grateful to smaller organizations such as local churches and visiting individuals who give time and gifts. We believe that involvement of our donors in our work builds understanding and friendships between people from different backgrounds and cultures and helps bridge the divide of privilege and poverty.

Management Structure

The operational management of the Keiskamma AIDS Treatment programme is overseen by a committee made up of staff members, community members and representatives of local primary health care clinic. This management team reports to the overall project manager employed by the Keiskamma Trust

The trust is managed by a board of directors.

Social and Psychological support

It is our vision that the center is seen as a place free of prejudice, accepting and caring for people who have been badly treated in the government program, unable to access government programs due to ill health and weakness, poverty, lack of knowledge, people who feel they have been rejected by society and the government health program. In 2007 we have tried to focus on children who are often not visible to health professions as they are part of large extended families, orphaned and grandmothers are over burdened.

In our outreach program in the district we have found a further 23 children in the area of which 8 have been initiated on ARVS. We offer support in the form of food parcels, transport and sometimes money to people trying to cope with the burden of HIV and AIDS. We are planning soup kitchens in many of the villages and have soup kitchens in some of the government clinics.

Children and Adolescents

In 2006 we Nokhaya Makewane and Betsy Coville initiated our memory box and children’s programme. To date we have held 3 children’s camps to help children over 10 years of age deal with grief, loss and illness. These have been very successful and will continue in school holidays.

In addition we now have a two village health workers who actively seek and care for vulnerable children in our area. This is the area where we hope our progamme will expand and develop. We hope to begin an active programme of prevention and life skills with adolescents in the district using peer educators and counsellors.

In Summary

The Keiskamma AIDS treatment program works in an impoverished rural area with an inadequate government health care system and seeks to assist the population and the government health system to provide good HIV/AIDS care for everyone.

Thanks

A special thanks to the many people who have been so generous with making blankets and jerseys, donating clothes, money and other gifts. To people who are used to discrimination and rejection due to their illness this personal and considered generosity in highly valued.